STORY ARCHIVE

Cosmetic Psychology

Shyness is no longer something people have to put up with. It’s now a treatable medical condition - just take a daily tablet.

But is this a miraculous new medicine or a step towards the psychological equivalent of cosmetic surgery... adjusting personalities with pills.

We film with a psychologist who thinks this is a dangerous development we should resist.

Another psychiatrist disagrees, saying chronic shyness is a serious condition suffered by up to 13 per cent of the population, and many shy people would benefit greatly from permanent medication.

TRANSCRIPT

Narration: Narration from ad: “What it is …what it feels like”

Narration: This American ad is talking about shyness – or social anxiety disorder as the drug companies prefer to call it. These days there’s no need to just accept your shyness. There’s a cure – a pill.

Narration from ad: “We know what social anxiety can feel like and Paxil can help.”

Narration: Is this medication a miraculous new cure or a step towards the psychological equivalent of cosmetic surgery…taking away the very things that make us human.

Narration from ad: “Life can feel like life again. Paxil…your life is waiting.”

Dr Sallee McLauren: We’re heading to the brave new world idea. If you take away what’s human about people, you can lose a whole lot of very important attributes. Like you might lose important aspects of sensitivity, important aspects of subtlety and intelligence and this is a very risky thing to be doing.

Narration: Paxil or Aropax as it’s known in Australia is one of the Prozac-like antidepressants. And while many psychologists say they meddle with human nature, psychiatrists like Graham Burrows claim they’re merely much-need medications.

Professor Graham Burrows: I don’t consider it meddling if in fact this person is suffering so much that it’s interfering with their life that they want to be changed. They want to feel more comfortable, they want to be able to deal with the social situations. They want to enjoy life when they’re not enjoying life. That couldn’t really be called meddling.

Narration: And this man agrees with him. ‘John’ wants to remain anonymous because of the stigma of him taking medication. But before he went on it, life was tough he says.

John: What would happen for example at a meeting people would be asking questions and it’d be my turn to say something. If I thought that the attention was focused on me then I’d always blush and somewhat stammer out an answer and so I didn’t feel I could really contribute in a meeting type situation just because of my shyness. It was like having a mask over my face.

Narration: Up to 13 percent of the population might be chronically shy like John, says Graham Burrows. And more than half of them probably need permanent medication to turn their lives around. Which John has done.

John: It’s like that mask had been taken away so that I could be myself. I can contribute and it’s a good feeling.

Narration: But psychologists like Sallee McLauren are horrified at the prospect of medicating such a large percentage of the population.

Dr Sallee McLauren: One of the central things with people who suffer from anxiety is the sense of powerlessness. They think that they cannot control the anxiety. Now this is simply not true. We can certainly learn to manage that anxiety. That’s why it’s very important for people who suffer from anxiety not to just adopt that passive approach of just popping a pill. It’s very important instead to learn how to be an agent in your own life. So how to stand up to the anxiety.

Narration: Psychologists teach people to stand up to their anxiety by changing their thinking patterns and teaching them coping techniques…It’s known as cognitive behaviour therapy - CBT. And there are regular classes for it at this Macquarie University clinic. Ross, like John, is terrified of speaking in public. But the drug-free approach is to face that fear and give a talk. It’s videotaped, so Ross can watch it back later, because part of the problem for chronically shy people is that they often think they’re worse performers than they really are. Pills are only a patch-up solution, say the psychologists, this cognitive behaviour therapy is the only way to get permanent changes.

Professor Graham Burrows: That’s not true and I’d disagree with that sort of opinion and that’s often a divided opinion between psychologists and psychiatrists, it depends who you go to because there are people who have claimed that the person can be well, but in fact when you take them off the medication they get bad again and you get back into the CBT and they still have problems, that’s when they have to face the fact that this person needs medication.”

Narration: Graham Burrows agrees CBT can definitely help people but chronic shyness can also be hard-wired he says.

Professor Graham Burrows: You find this social anxiety often runs in families. It’s a genetic predisposition to it and we’ve now got you know, grandmother, mother and daughter who have the same disorder.

Professor Graham Burrows: There are people who have abnormal biochemistry in their brain. We can show that by blood tests. We can show that with positron emission tomography a neuro-imaging technique. We’ve done some studies to show that they actually have altered chemistry and by giving them the medication, their chemistry is converted back to normal if you like and they don’t have the anxiety and the depression they had beforehand.

Narration: But the concern is, we’re got a medication here, that’s being heavily promoted, the drug company sells billions of dollars worth of it each year, yet they don’t know that much about it. Science thinks the drug works by altering the serotonin levels in the brain.

Narration: Serotonin is one of the chemical messengers one brain cell uses to communicate with another. It ferries signals across the gap between the brain cells – the synapse. Serotonin is created on one side and normally, once it’s got to the other side and delivered its message, it’s reabsorbed and disappears. But take the shyness drug and reabsorption is slowed, bathing the brain in serotonin and reducing the shyness. Sallee says this is no more than just a theory.

Dr Sallee McLauren: At this stage we don’t actually know whether anxiety is related to too much serotonin, not enough serotonin. We’re not even really certain that’s it’s serotonin.

Professor Graham Burrows: I don’t think there’s anyone in the world today who could emphatically say how an anti-depressant works – whichever antidepressant group and having said that we do know a lot of chemistry about what actually occurs. Now I sometimes say does anyone know what electricity is, but we use it.

Narration: Whether or not John’s medication is cosmetic psychology, there’s little doubt it’s taken away his shyness. He couldn’t walk up to strangers before. But what remains to be seen is whether it’s safe and the best long-term solution.